Talk to any parent and you’re bound to hear at least one horror story about “that time” their child ate something that did not belong in his or her mouth, let alone the digestive tract. (Among my arsenal of standout tales is the time a friend’s 2-year-old son merrily noshed on a dehydrated pellet of fecal matter he’d adventurously discovered on the floor of an airplane restroom while wriggling away from his harried mom.)
But for some kids, the urge to eat inorganic objects can become an obsession stretching beyond the normal developmental stage of “oral fixation,” where anything from one’s own toes to the shiny fridge door may be nibbled or sucked. Pica refers to “the persistent eating of substances that have no nutritional value,” and it’s most commonly associated with women who desire things like dirt or chalk during pregnancy (it’s been suggested this is because women may crave these specific substances to make up for missing mineral nutrients or to counteract nauseating toxins released during pregnancy). In her book about the culture of eating clay (which goes as far back as biblical times), Sera L. Young suggests that this craving is more common in the tropics, where pathogenic viruses and bacteria are more prevalent. However, the precise pathophysiology of the syndrome is unknown. Given the shame associated with the condition, medical studies are sparse. There are theories that suggest a relationship to iron or other mineral deficiencies, or even desperation among kids who are not given proper meals at home. It was recently reported that hospitalizations for people who had dined on objects like dirt, chalk, and paint had nearly doubled within a decade, and in 2009, 31 percent of childhood pica cases were found in autistic children, which has led some to conclude that this uptick could be related to the higher rate of autism diagnosis in America.
Here, a single mom from Chicago describes life with her 9-year-old son who likes to eat magnets, paper, clothing, crayons, plastic, and anything coated in rubber.
Tell me a bit about the first time your son ate something inorganic.
When he was a little baby, he loved chewing on his pacifier. He’d nibble the heck out of it, but I just thought, Oh, he’s a baby. It’s normal to chew things. When he was 2, he was diagnosed with “sensory processing disorder.” Chewing on things is one of the ways kids with this condition relieve themselves. But then he started biting and swallowing things.
What was he swallowing?
Say I gave him a Nerf ball: He’d down the whole thing. He’s a huge reader, so he would eat the sides of his books. But mouthing on books is not “abnormal.” And most toddlers and babies chew, eat, and lick.
So what set him apart?
He loved to eat dirt and sand. As a mom, you kind of think, My child’s a bit unusual, but there’s nothing “wrong” with him. I was just like, Okay, he likes to eat that. Ew, but, Sure, do your thing … Then he developed a really strong bite. I even tried giving him dog toys — he still has a couple he can chew on. But the problem with dog toys is they break apart: Kids’ mouths don’t open up that wide. He has a few of those fake plastic doggy beer bottles because my sister’s dog was living with us for a while. I washed his toys up, and he chewed on them. He tried chewing on gum, but he just swallowed the whole package. I think the moment I realized it was becoming a “problem” was when he ate the magnet. He was in preschool at the time.
A magnet? Wow, did he digest it? What sort of magnet?
It was one of those photo frames that you put on the fridge. I figured out what he’d done when I went to clean his bedroom and I found the leftovers. It looked like somebody had spat out a hamburger. It was in pieces. I asked him if he ate it, and he said “Yes.” He hides things, but he’s very honest, especially at 4 years old. I took him to hospital, and that’s when he was diagnosed with pica.
What was that like?
A parade of medical students and doctors came to see him because it was so unique. Some doctors really don’t seem to understand it. I’ve heard them say, “Don’t eat those things!” That’s like telling somebody with OCD, “Don’t lock the door ten times.” It doesn’t work like that. Sometimes he doesn’t even notice what he’s doing.
What exactly is sensory processing disorder, and how is it related?
People actually have seven senses. One is the equilibrium of your balance, another is the feeling of where you are in space — how close I am to things. My son could not feel where he was, so he would run into walls on purpose just so he could feel. He would react to touch. He loved swinging; he would swing for a good hour. Some kids can’t handle certain textures in their mouth because it really bothers them, and normally you would go, Okay, this kid is autistic.
As an adult, you learn how to get control of it. But when he gets tired, it’s harder for him to control these feelings. He loses any sense of personal space when he starts having his problems. He’s asking for hugs constantly and physically smothering me. If he has a bad night, he asks for this really heavy blanket to put on his body to calm down. He craves being touched. He wants to be held all the time. He wasn’t ignored as a baby; he was very much given affection. He craves that feeling of being smothered. Even when it’s 80 degrees in the house, he’ll have a blanket on top of him. Being smothered is a feeling he craves.
Can you talk me through the various treatments he’s had, or his various encounters with doctors?
The majority of the doctors I’ve seen dismiss the issue. I’ve been told that if you want to treat pica, you have to embark on an intense program of behavioral therapy, and there are only a few behavioral therapists in the country that offer the treatment. It’s expensive and not covered by Medicare. So the normal response is to ignore it, I think. A lot of therapists hope that he’ll grow out of it or maybe that he will figure out how to satisfy his appetite in a different way.
How do you manage it on your own? What sort of things is he likely to eat, and what situations do you have to avoid?
The problem is that the things he eats are so common you can’t keep everything out of his way. For example, he eats his shirts, so his clothes are covered in holes. You know how cigarette smokers get holes on their shirts because they ash on themselves? You can imagine what his shirts look like. Even in winter, I don’t allow him to wear long-sleeve shirts unless it’s extremely cold. He finds alternatives: He chews the collars of his shirts. I’m sure his friends’ parents think that I’m smoking and ashing on him. He’ll pick his socks apart and chew on them. We have a Kleenex procedure.
What’s the drill?
When he wipes his nose, he has to return the Kleenex, otherwise he’ll eat it. I have to control his toys. Many doctors don’t understand exactly how much I have to monitor. He’s so sneaky about it, too. Yesterday, he was lying on the couch and I was working on my computer. He was playing on his video games — they have the consoles that have the little wire that hooks to it, and I’m watching him, and he’s playing the device. But he already put the wire of the console in his mouth, and he’s just mouthing it, and I have to yell at him, “Don’t chew that!” And he goes, “I’m not doing anything!” He quickly gets it out. I can tell that he didn’t even notice the fact that he had put it in his mouth. It’s stuff like that. If it’s covered in rubber, he wants it and there’s nothing I can do.
I’m imagining a lot of plastic rubble.
His Wii remotes are all chewed up. We’ve had to replace them a couple of times because as he’s playing he’ll start chewing on them. We often have to replace remote controls because he eats the buttons. His pencils don’t have erasers. He eats the whole pencil, so thank goodness they no longer make them with lead. He’ll eat the bottoms of shoes and walk up to edges of counters in restaurants or whatever and just start sucking on them.
You know when you’ve been having McDonald’s a lot, kinda let go, and then you go to clean out all the wrappers from the car? I’d always note that there weren’t that many wrappers to throw away. I thought, Huh, maybe he’s throwing things out of the window, and one day it dawned on me there was no way because I would have seen all this garbage flying out, plus it was the middle of winter — I would have noticed him open the window. I finally figured out he’s eating the wrappers. That really alarmed me. He’d get Happy Meals and eat the entire meal. The box. The wrappers. The straws. The lids. The toys. Thank God, the toys are plastic.
Are things different when he’s among friends?
When he goes to birthday parties, they love to give those little goody bags. He’s learned that he has to let me remove all the contraband. For instance, plastic toys. When he has his own birthday parties, he doesn’t get presents from his friends or family because he’ll eat it — the whole gift — and I don’t want to embarrass him.
That must be tough for a 9-year-old. How does he cope?
Well, we worked out a plan: Instead of gifts, we ask for donations to the Brookfield Zoo. He loves animals. And we use the donations to adopt an animal. When you do that, the zoo will send a soft stuffed-animal toy as a thank-you. He loves stuffed animals, and he can chew on them safely. They’ve all been chewed on, but stuffed animals don’t show the impact. I only know what he does with them because sometimes I see him with the toys in his mouth. But interestingly, I think he regards them as friends, so he kind of spares them. Those toys just might be his best friends.
When it comes to schoolwork, there are challenges. He’s encouraged to use the computer so he doesn’t eat stationary. He eats crayons, lots of kids do, but he really gets into them. I have to replace them all the time. They’ll be sitting in the basket, and he sees the crayons as a bowl of food.
It doesn’t sound like you have much more faith than the doctors that things will get easier, or even resolve themselves, over time.
Every mother worries about her child. When it comes to his pica, I worry about the social impact. If he’s bullied, he either ignores it or is not aware of the fact that he’s being made fun of. But I know when middle school and high school happens, especially when he starts integrating with kids he hasn’t known his whole life, he’s going to face some tough situations. I wonder: Will he learn how to control it so nobody sees what he’s doing? Is he ever going to stop?
What was his eating like when he was a baby?
I’ve been a single mom since before he was born. We live in the same building as my parents, so they are a great support. I breastfed until he was about 2 months old, then he gave up. I had to go back to work, anyway. But when he started on solids, he ate everything. Well, he would try everything.
Is that still the case?
No, these days he’s definitely very picky. His taste buds can only handle bland foods. He doesn’t like anything spicy: His tongue can only take salt and pepper. The inorganic things he eats must taste different to him, because everyone’s tongue is different. Put a bowl of ice cream in front of him and he’s a typical kid.
But he does have ADHD, which means there are some impulse-control issues, so he does a lot of binge eating.
Do you feel there’s any connection between the ADHD and pica?
I am not sure if there is a connection, but his ADHD medication does help control the impulse to eat things. He can think before he does something. Not to say that the craving can’t still get the better of him.
Is he a very sensitive child?
He gets very worried about some very heavy things — things you would not expect a child to feel for. For example, he hates Trump. Whenever he hears anything about him, his stress levels skyrocket. He’s a very open, loving child, and he can’t understand injustice. He picks up the world’s emotions. Whenever the family is going through stress, whether or not they tell him what’s going on, it definitely increases his appetite for nonfood items. When school’s getting too much, I see the eating increase. He’s in an accelerated academic program, so the pressure of his classroom can get quite intense, but he’s too smart not to be there, and also he would be a terror in a normal classroom.
Does he crave or binge on inorganic things when he’s emotional or has had a bad day?
I do notice his problems get worse when things in life get tougher. Say school is demanding or my mother and I are butting heads. I know that when things are bad, all I want to do is eat chocolate and get a gallon of ice cream. So lately he’s been chewing on his shirt during class because school can be very stressful: He has social issues, academic pressure, performance anxiety. And he’s an anxious kid. He worries about things that are not necessary for him to worry about. He’ll listen to NPR with me and gets very upset about political issues, environmental issues, and racial equality. His father is African-American, and I’m white. If he doesn’t like what somebody is saying, he calls them a racist.
Did he grow up with his father? Does he see him at all?
They don’t have any contact. He’s had male influences in his life, but not his dad. We’ve been living with my parents since the day he was born, so my father has been here for him. I have an African-American male friend who has had a kind of uncle role for him.
Has his ethnicity been an issue socially for him?
Definitely. I’m sure it’s subconscious for a lot of people, but they stereotype my son as the naughty African-American boy. If he starts getting upset about something, they see him as the bully. For instance, he was at a really prissy camp that he got a free scholarship to for a gifted program. When he was there, he got in trouble for hitting a kid. When I asked him why, he said that kid was not allowing other kids on to the playground equipment, and justice is his No 1 issue. And that’s why the school has not classified him as a bully. He gets upset when other kids don’t follow the rules that they’re supposed to and get away with it, and he’s kind of like looking at the adults like, Are you going to say something? And when they don’t, then he hits them and takes care of the issue.
Where do you think he got the strong sense of justice?
My dad’s a lawyer, and my mom and I are activists. We often talk about treating people in an equal and just manner. He’s often seen me speak up for people or stand up for what’s right and against what’s wrong. We live in a very integrated neighborhood in Chicago. There are a lot of mixed couples here with mixed children, but we might be out in situations either all white or all black, and I can see he’s treated differently. Right now, he’s a child, but when he becomes a teenager and I’m not there to intervene, it might become a problem because he can get violent. We recently had to talk about the police and stuff because he is riding his bike around and he is big for his age — what will happen if he got angry with a cop? I have had to have some very adult conversations with him at a young age. But I believe that’s important anyway. Like sex education, I talk to him about that too. I must say, though, he’s still very skittish about all that. Last week he went to Florida, and he was supposed to kiss a dolphin, and he was like, “No way, I’m not kissing that,” and walked away while all the girls took turns to kiss the dolphin.
Still, that seems pretty normal for a preteen. How unusual would you say his social life is at this age?
He has the benefit and disadvantage that he’s been in the same classroom since first grade, so he’s been with the same set of kids for pretty much this whole time, and they know the weird things he does. But I can see that, socially, he’s on the outs. He doesn’t notice. For example, he hasn’t been invited to any birthday parties this year. We always invite the whole classroom to his. I think, as he’s getting older, he’s at that age where kids pick who they’re inviting as their friends. Their parents have less say …
In addition to ADHD, he also has oppositional defiant disorder, so when he gets angry, he gets panicked and violent. His classroom all saw it back in first grade. Unfortunately, like I said, the disadvantage of being in the same classroom is those stories stay with them. Now that he’s on medication, he’s much calmer, a sweet kid. The kids do like him, but they notice that something’s different. At 9 years old, when something’s different, you stay away. I ask him if he wants to call his friends, and he says “No.” But you know he takes after me and my family. We’re definitely social, nice people, but building a big group of friends is not our top priority.
You must have to do so much monitoring too.
Gosh, yes. And you know, this is kind of weird to talk about, but he doesn’t flush the toilet after he makes a No. 2 because I want to check his feces to see if there’s anything in there that I need to be alarmed about. I mean I don’t physically go through it, I just take a quick look and say, “Oh, it looks normal to me, now flush.” I’ve gotten complaints from his school because he doesn’t flush. When he was in preschool, he was eating a lot of crayons: It would come out red, and I would have to call the school and figure out what the heck it was. So anytime he ate a red crayon, they would report back so that I wouldn’t assume it was blood. The one thing I have to worry way more than other mothers is when he starts complaining of a tummy ache. I usually think, Oh, no, finally all this stuff in his tummy has impacted him. Of course, it’s usually just a typical tummy ache, and the doctors never worry unless he’s bowing over in crippling pain or throwing up with diarrhea. But of course I worry. Maybe he finally ate something really harmful. I’ve had to learn to calm myself down. As a pica mother, I’m very fortunate that my son eats soft things that the body can’t digest, so they just pass through. Even though he’s into plastic, he chews it up so much that it makes it out. But each time I worry, what if it does not go through or what if it finally makes him sick?
If he eats something and then realizes he’s not sure it’s gonna make it, does he tell you?
No. If he has a tummy ache, I ask, “Did you eat anything today other than food? And he’ll be like, “No, Mom.” Then I ask again, and we will talk it through, like, “Okay, are you sure, did you eat any paper?” The majority of the time he says “No.” And kids get tummy aches. Usually he’s constipated and didn’t go to the bathroom, so I’ll make him go to the bathroom, or if I don’t believe him, I will have to do some detective work to put it together. On the way to camp, he ate through his vaccination records.
Does he ever talk about why he eats these things? Does he ask “Why do I eat this and nobody else does?”
I’ve explained to him what pica is, like he can’t control himself, but at the same time he’s got to learn how to figure it out. But he’s never asked: What’s wrong with me? I guess we’re gonna have this conversation, but at the moment I try to explain to him that everyone in life has things that they have to work on and that he just has an incredible list of things that he needs to address.
When he first started school, he had a friend who used a walker. And I said to him it’s just like this person having a walker to walk, she needs help. You need help. But with her, you can see that she needs help. That’s the difference: Other people think that he’s “normal” and that’s because they don’t see the issue unless they spend time with him.
Do you think he feels guilty about his habit?
Sometimes I think he feels like he’s a little different. You know, when you’re eating a package of cookies? You only have three and then you go, What the heck, it’s all gone? I don’t think he does it intentionally, like sets out to eat it. I’m sure there are times when he’s hungry, although there’s always food, and for whatever reason he forgets to ask, “Hey, Mom, I would like to have food.” Instead, he’ll go eat things around him. For instance, the vaccination records: His excuse was that he was hungry. I was like sitting here going, “I have tons of food in the front seat with me that I could have given him if he had told me that he was hungry.”
Have there been any incidents that were particularly scary?
About a year ago, he came out of the bathroom and he goes, “Mom, there’s something in my butt.” And I go, “What are you talking about?” As a mom, you gotta do what you gotta do, so I told him to bend over and turn around. There was a string hanging down, you know, like when you have a tampon stuck too far up — it was the same kind of situation. So I kind of tugged at it, it wouldn’t come. I was really worried it might be looped around his intestines or something like that, so we had to go to the hospital. The doctor did an X-ray and then just pulled it right out. My son’s stomach must be incredibly sturdy, the things he’s eaten that have gone right through! Like I said, there’s many times where I’ve called the doctor in the middle of the night when he’s complaining he’s upset with the tummy and the doctor will tell me it’s okay.
It must be hard for you to focus on yourself, your work. Are you able to maintain a full-time job?
Before I had my son, I was working with teenagers. When I became pregnant, I knew I had to take a mental break from social work with young people. I took a job in the travel industry and worked up until the recession in 2008. My mother is a big proponent of mothers being with their children when they’re young, so she said she would help me look after him. I ran a day care from home, and I was also going to go to school to get my master’s in elementary education, thinking that when my son when off to kindergarten, I would go back to work being a teacher.
Unfortunately, the timing of everything did not work out. Student teaching didn’t work out, so I was jobless probably three, four months, then I got a job in child care. I was working at a very nice one when my son was in first grade and he started having a lot of problems in school, getting in a lot of trouble, so the doctor recommended that he be put in a special program for three weeks where he would have to go to the hospital every day before school to figure out what was going on with him. Was I the problem? Was it school? That’s when he was diagnosed with all these disorders. I knew I couldn’t continue to work in child care full time because I had to commit to these kids and my son. I found a part-time nannying job, but eventually she needed me to be there all the time, so I had to leave. I was also supplementing my income by working for GrubHub after hours. I have a master’s degree, but this job gives me what I need to take care of my son. And the schedule is flexible.
I’m embarrassed about it, but it also allows me to be the mom that my son deserves, and it wasn’t fair on the other kids. If I had to take a day out because there were problems with my son, I’d have to reestablish a relationship with them, so this setup makes sense. Financially, it is not the best — I’m living paycheck to paycheck. I don’t get any child support, but my parents have been a hell of a support. My father’s a lawyer, my mother works for the government, so there are three of us to bring in enough money to take care of him and to give him the life a lot of kids don’t get. They help out because the rent here is very low; they pay for the food, but I do all the cooking and shopping. He’s surrounded by a working family.
Do you think about finding a partner or having more kids and having a family apart from your parents?
I don’t have time to seek out a perfect man who will take care of me and my son, but it’s definitely something I would like. As a single mom, I feel guilty if I’m spending time with somebody else other than him. I’m letting God or whoever take the reins on that one. I’m not thinking about my looks or how to attract the opposite sex. I look like a frumpy, old mom. But I know my son gets upset he doesn’t have a brother or sister. Sometimes he will say: “Mommy, who’s gonna take care of you when I leave?”